A school nurse is providing care for students in an elementary education facility. Which of the following interventions by the nurse addresses the primary level of prevention?

A. Provide educational in-services for staff: While staff education is an important component of a quality improvement project, it is not the first action to take. Understanding the underlying factors contributing to MRSA infections should be the priority to ensure that educational initiatives are targeted and relevant.

B. Develop a MRSA protocol for implementation: Developing a protocol is necessary for guiding practice and reducing infections. However, it is essential to first gather data on existing practices and factors contributing to MRSA infections to ensure the protocol addresses specific issues.

C. Evaluate outcomes resulting from interventions: Evaluation of outcomes is a crucial step in the quality improvement process but occurs after implementing interventions. Initial actions should focus on identifying the root causes of MRSA infections before assessing the effectiveness of any interventions.

D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA: Conducting a chart review is the first action the nurse manager should take. This step allows for the identification of patterns and factors contributing to MRSA infections, providing valuable data that will inform the development of effective protocols and interventions tailored to the facility's needs.

A. Loud volume of the television set. While a loud television may indicate hearing impairment, it does not pose an immediate safety risk. The nurse should assess the client’s hearing and provide recommendations if needed, but addressing environmental hazards that increase the risk of falls takes priority.

B. Wall-to-wall carpet in the living room. Unlike loose rugs, wall-to-wall carpeting reduces the risk of tripping and slipping. It provides better traction for walking, making it a safer flooring option for older adults compared to hard surfaces or throw rugs.

C. Low chairs without armrests. Low chairs make it difficult for older adults to stand up, increasing the risk of falls. The absence of armrests further reduces stability and support when rising from a seated position. Recommending higher chairs with armrests can enhance mobility and prevent injuries.

D. Use of indirect lighting. Soft, indirect lighting can help reduce glare and improve comfort, but it may not necessarily create safety concerns. However, inadequate lighting in critical areas, such as hallways or staircases, should be assessed to prevent falls.